Combined care for spinal stenosis describes a multidisciplinary approach to treatment. Combination care can be very effective at relieving pain, since it uses a variety of therapies that work well together. Combined care has become a popular nonsurgical therapeutic strategy for a wide range of problematic back and neck pain concerns, including spinal stenosis.
Combination care may be sought using different unrelated care providers, but is more commonly offered in a dedicated facility housing a combined care practice. These healthcare entities are self-contained and offer a full selection of treatment choices all under one unified roof. These practices make seeking treatment very easy for the patient, since no travel is involved between caregivers. Additionally, billing is simple and handled by a single centralized office section for all providers.
This essay defines and examines combined care for foraminal and central stenosis patients. We will provide a detailed evaluation of the benefits of combination treatment, as well as caution patients on the common pitfalls of this approach.
Combined Care for Spinal Stenosis Definitions
Combination care is defined as using multiple noninvasive care methods to treat a single diagnosed condition. In the case of central spinal stenosis, symptom management is the goal, even though the underlying cause of symptoms is left unchanged in virtually every circumstance. In foraminal stenosis cases, symptom management is also the primary objective, although some methods of care have a better chance of resolving the underlying causative source in rare scenarios.
Combination care techniques are rarely curative, but some, such as nonsurgical spinal decompression, might provide true and lasting resolution of particular types of (mostly disc-related) stenosis concerns. However, most practices qualify as purely symptomatic treatment and therefore will only help the patient to live better and with less pain, but will not ever provide a cure for the stenotic problem itself.
Some of the most common complementary combined care techniques include chiropractic, hydrotherapy, prolotherapy, massage, reiki, ayurveda, acupuncture, acupressure, meditation, TENS, Alexander Technique, diet therapy, hypnotherapy, pain coaching and exercise therapies like yoga, tai chi or Pilates. Traditional medical therapies can also be integrated in a combined care approach and usually include physical therapy, epidural injections and oral or topical pharmaceutical treatment.
Combined Care Benefits
Combined care is highly effective compared to singular forms of care, since it approaches pain management from multiple angles. Not all patients respond to all manner of care practices, so a diversity of techniques stands a better chance of providing effective symptomatic reduction when contrasted against a singular therapeutic modality.
Combined care allows patients to receive multiple types of pain control from care providers who work well together and are aware of the other types of treatment being used in each patient’s case. This synergy of care targets each symptomatic expression from a customized point of view, with each patient able to receive therapy which is specifically tailored to their condition and treatment response.
When combined care is offered in a single facility, the patient enjoys convenience of seeking treatment, as well as less paperwork to manage, since all billing is performed by a single central office. For patients with busy schedules, limited travel ability or severe pain problems, this centralization of care can be a fantastic positive factor.
Combined care allows patients to avoid the risks and injury of spinal stenosis surgery, which can be a very good thing. Combination care can also facilitate a greater range of therapy choices that can allow a patient to be free from more dangerous treatments, such as injections or drugs, in favor of natural and holistic care techniques, such as coaching, chiropractic or massage.
Combined Care for Spinal Stenosis Warnings
Not everything is positive when it comes to seeking combined care. There are certainly some possible downsides of combination treatment that may also apply, so patients are strongly advised to consider these negative characteristics carefully, as well as to evaluate each combined care practice objectively before agreeing to receive therapeutic services.
Spinal stenosis is one of the few back or neck pain sources that actually does often respond well to surgical treatment. For patients who can be truly and permanently cured using a minimally invasive operation, combined care is not ideal. Surgery is a finite expense and can lead to an unrestricted life postoperatively, while combined care requires ongoing financial expenditure, as well as literal dependency on long-term treatment. Singular noninvasive care techniques, such as spinal decompression, can also cure certain types of stenosis without the need for expensive ongoing care.
Some combination practices are actually thinly disguised medical mills where patients are financially exploited over long timelines. In these cases, the patient might receive unnecessary, contraindicated and ineffectual treatment simply to make the practice more money. While some patients do not care if their insurance or government program has to pay more for these billed services, it is wise to remember that we all pay the increased cost of insurance and we all pay taxes, so we must all do our part in stamping out fraud and exaggerated billing in all forms. Doctors and therapists already earn on the very top of the income scale, so there is no justification for these types of greedy practices. No patient should have any sympathy for a doctor or healthcare practice that is involved in medical milling.